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primera etapa > multisystem > Flashcards

multisystem Flashcards

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1
Q

photosensitive blistering rash associated + brown urine

dx, tx?

A

dx: porphyria cutanea tarda

tx:
1. flebotomia
2. hidroxicloroquina ( contraindicaciones: retinal disease, advanced liver disease, renal disease, psoriasis)

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2
Q

etiologia de porfiria cutanea tarda?

A

deficiencia enzima Uroporfirinógeno descarboxilasa

asociado a hep c

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3
Q

disuria+hematuria+oriente medio/africa

dx, tx?

A

dx: Schistosomiasis

tx: praziquantel

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4
Q

Sd de kawasaki sx

A

“CRASH-B”

Conjuntivitis no purulenta
Rash
Adenopatia
Strawberry tongue
Hands and feel edema

Burn > fiebre por mas de 5 dias

asociado a descamacion de los dedos y ANEURISMA CORONARIA

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5
Q

Beckwith-Wiedemann syndrome

que screenings se le hace?

A

este sd tiene riesgo aumentado de neforblastoma, hepatoblastoma, neuroblastoma, entonces se hace

US abdominal cada 3m por 8 años
medir Alfa fetoproteina cada 3 m x 4 años

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6
Q

diarrea severa que desorden acido base y electrolito?

A

met acidosis ( ph bajo, hco3 bajo)
HIPOkalemia (k bajo)
HIPERcloremia (cl alto)

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7
Q

metodo mediante el cual sarcoidosis causa hipercalcemia?

A

1,25-dihydroxyvitamin D3 increase (calcitriol) intestinal calcium absorption resulting in hypercalcemia

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8
Q

cual tipo de shock pone la piel “flushed”?

A

shock septic

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9
Q

en que parte anatomica debe estar el catater venoso central y q se hace apenas s epone?

A

vena cava superior (lower segment)

se confima su posicion con radiografiade torax

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10
Q

vomito severa que desorden acido base y electrolito?

A

alcalosis metabolica (ph alto, hco3 alto)
HIPOcloremica (Cl bajo)
HIPOkalemica (K bajo)

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11
Q

What vitamin should be orally supplemented in breastfed infants?

A

vit d

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12
Q

What electrolyte abnormality is typically the cause of hypocalcemia in a patient with alcohol use disorder?

A

Severe hypomagnesemia

↓↓ Mg2+ = ↓ PTH = ↓ Ca2+

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13
Q

Why does normocytic anemia in a patient with CKD occur y como estan los reticulocitos?

A

anemia of chronic disease in CKD due to Decreased production of EPO

retis bajos (<0,5%)

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14
Q

Mees lines (White bands across the nails of fingers and toes) + Hiperkeratosis + distal sensorimotor polyneuropathy

dx? tx?

A

arsenic poisoning

tx: dimercaprol or succimer (in children).

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15
Q

cancer anorexia-caquexia sd

tx?

A

Megestrol acetate (analogo de progesterona) o corticoesteroides

These drugs act as appetite stimulants, increase well-being, and counteract proinflammatory cytokines responsible for cachexia

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16
Q

Diffuse desquamating rash involving palms and soles

dx?

A

toxic shock syndrome

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17
Q

nexus criteria for cervical spine imaging?

A

NEXUS criteria provide indications for cervical spine imaging:

“NSAID”:

Neurologic deficit
Spinal tenderness
Altered mental status Intoxication Distracting injury

PERFORM CT SCAN

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18
Q

heterophile antibody test positive?

dx? causative agent? prevencion? tx?

A

dx: mononucleosis infecciosa

Epstein barr virus

Avoid contact sports for 1 month due to risk of splenic rupture

tx: sintomatico

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19
Q

miositis+periorbital edema+eosinofilia

dx, modo de transmission, tx?

Study These Flashcards
A

dx: Trichinella spiralis (helmitio aka gusano)

modo de transmission: undercooked meat

tx: mebendazole/albendazole

recuerda: eosinophilia es eosinofilos >3%

20
Q

hemocromocitosis

que sale en el examen de sangre y diagnostico confirmatorio?

Study These Flashcards
A

hx familiar de hepatocellular carcinoma + iron aumentado, transferrina aumentada >45% + ferritina aumentada >200 premenopausicas o >300 todos los demás (indica iron overload)

dx: genetic testing HFE 282Y. auto recessive

21
Q

como esta el volumen residual en una enfermedad obstructiva cronica respiratoria?

Study These Flashcards
A

aumentada, debido a atrapamiento aereo

22
Q

bacilo gram +, filamentado, acido resistente

que microorganismo, tx?

Study These Flashcards
A

Nocardia

causa infección pulmonar, piel, SNC en Immunocomprometido

tx: TMP-SMX (agregar imipenem si hay infecciones sec)

es una bacteria FILAMENTADA eso es muy característico

23
Q

drugs that induce lupus?

Study These Flashcards
A

“SHIPP”

Sulfa
Hidralazina
Isoniazina
Phenitoina
Procainamida

Anti histone anticuerpo «< Para drug induced lupus

24
Q

agentes causales de rash in palmas y plantas de los pies?

Study These Flashcards
A
  1. Coxackie (Hand, foot, and mouth disease usualmente <10 y.o)
  2. Fiebre de las Montañas Rocosas: agente causal Rickettsia rickettsii. Tx doxicilina. rash starts on the wrists and ankles and spreads to the trunk, palms, and soles. It becomes petechial and/or hemorrhagic in ∼ 50% of cases.
  3. sifilis secundaria
25
porfiria aguda intermitente sx, dx?
sx: 5P Polineuropatia Painful abdomen Purple urine Psicologícal abnormalities Precipitated by medication: sulfas, barbituricos como fenobarbital y primidona y fenitoina no hay sx dermatologicos dx: aminolevulinic acid and porphobilinogen increased in urine
26
que medicamento produce como efecto secundario intoxicación por cianuro, que acido base esta asociado y para q se usa
Nitroprusiato de sodio, usado en crisis hipertensivas puede causar intoxicación por cianuro y acidosis metabolica con anion gap aumentado debido a la producción de acidosis láctica
27
enfisema de lobulos INFERIORES + enfermedad hepatica dx?
alfa 1 antitripcina deficiencia es importante que es enfisema de lobulos INFERIORES, ya que el enfisema de los fumadores es en lobulos superiores usualmente pacientes jovenes, sin mayor hx de fumado
28
como la apnea de sueño causa hipertension pulmonar?
apnea del sueno causes hypoxic pulmonary vasoconstriction >> increase pulmonary pressure >> RV disfunction >> Impaired function of the right ventricle due to pulmonary hypertension resulting from a primary disorder of the respiratory or pulmonary artery system is referred to as cor pulmonale.
29
restrictive cardiomyopathy+macroglossia dx?
AL amyloidosis.
30
en que enfermedad esta presente Low voltage QRS complexes?
restrictive cardiomyopathy por AL amyloidosis
31
alguien que esta haciendo scuba diving asciénde a la superficie muy rapido. tx?
enfermedad por descompresión tx: camara hiperbarica 100% oxigeno
32
recurrent oral ulcers+genital ulcers+uveitis dx?
Behçet disease PATHERGY: Positive pathergy test, Aphthous oral ulcers, Thrombosis (arterial and venous), Hemoptysis (pulmonary artery aneurysm), Eye lesions (uveitis, retinal vasculitis), Recurrent Genital ulcers, Young at presentation (3rd decade)
33
hiperKalemia sintomatica tx?
gluconato de calcio + insulina +dextrosa gluconato de calcio estabiliza la membrana cardiaca y insulina+dextrosa ayuda a intracelular K shifting si K <6 + no sintoma: no tx, restriction of potassium intake, adequate hydration (to enhance renal potassium elimination), and discontinuation or replacement of contributing drugs; Potassium levels should be normalized prior to surgery, as hyperkalemia increases the risk of perioperative arrhythmias.
34
que es fiebre de origen desconocido y que imagenes se hacen de primera instancia?
> 38.3°C for > 3 weeks imagenes: 1. Chest X ray 2. TAC abdomen y pelvis Resolution of fevers with naproxen indicates that a malignant etiology is likely.
35
anti-U1 RNP antibodies + dx?
Enfermedad mixta del tejido conjuntivo
36
What is the likely diagnosis in a sexually active patient that presents with fever/chills, polyarthralgia, and skin lesions on the chest and extensor surfaces of the forearms?
disseminated gonoccocal infection due to gonorrhea (gram - diplococo) triada de artritis-dermatitis sindrome: 1. poliartralgia migratoria 2. lesiones en piel 3. tendosinovitis
37
decreased peripheral pulses + night sweats+ joint pain dx? cual es la población mas afectada?
takayasu arteritis, mujeres <40 y.o Takayasu arteritis is associated with a(n) weak or absent pulse in the upper extremity tambien asociado a eritema nodular de la piel
38
cuales son los sx de porfiria aguda intermitente? tx?
5P Painful abdomen Polineuropatia Psiquiatríc sx Port urine (orina roja) Precipitated by drugs : barfituricos, fenitoina, sulfas, alcohol, acts tx: hemin
39
artritis+vesicular, pustular, macular skin lesions dx?
Arthritis-dermatitis syndrome due to gonorrea
40
alopecia, diarrea, dermatitis, delayed wound healing, impaired taste dx?
zinc deficiency ocurrs due to chronic alcohol use or decreased intake no confundir con diarrea, dermatitis, demencia x deficiencia de b3 niacina
41
asociaciones de down sd?
The 5 A’s of Down syndrome: - Advanced maternal age - Atresia (duodenal) - Atrioventricular septal defect - Alzheimer disease (early onset) - Acute Mieloid Leukemia (<5 years of age)/Acute Linfocytic Leukemia (>5 years of age)
42
Holoprosencephaly en que se ve?
Patau syndrome fetal alcohol syndrome
43
como se ve la alcalosis metabolica en acido base?
ph Aumentado hco3 Aumentado
44
tx atb empirico sepsis?
cefepime+vancomicina
45
tender calves+conjunctival suffusion dx, tx?
leptospirosis tx: doxiciclina
46
cherry red spots in macula de un bb dx?
Tay-Sachs disease due to deficiencia hexosaminidasa A lo cual lleva a acumulacion de gangliosido en SNC
47

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